4092 1 Acute Renal failure Flashcards
ARF: most accurate measurement of fluid status
daily weights
ARF: Amount of fluids to be taken per day
400 ml (insensible fluid loss) + previous days urine output
ARF: for comfort give
ice chips
ARF: Diuretic therapy is usually done with
Furosemide and Mannitol
ARF: Hyperkalemia can be an indication for
dialysis
ARF: If there is Emergency Hyperkalemia
give 50% dextrose and regular insulin
ARF: for acidosis give
sodium bicarbonate
ARF: avoid ___ substitutes
salt substitutes
for Hyponatremia, you need to restrict
fluids
Treat “normal” Hypocalcemia
- Calcium Carbonate
- Calcium Lactate
- Vitamin D
treat Emergency Hypocalcemia with
Calcium Gluconate IV
Hyperphosphatemia is treated by phosphate binders like
Aluminum hydroxide
Aluminum Carbonate
Aluminum Carbonate (which is a phosphate binder) – if use for a long period, this can caused
dementia
Aluminum hydroxide (which is a phosphate binder) – can cause
constipation so stool softener maybe given
Calcium base phosphate binders – excrete phosphorus but increased
Calcium
Emergency Hypermagnesemia: Give ___ ____
Calcium Gluconate
Treat “normal” Hypermagnesemia with ___ ___
diuretic therapy
ARF: Metabolic Acidosis is associated with what electrolyte status
Hyperkalemia
treatment of metabolic acidosis that’s caused stomatitis
Shohl’s solution
Hyperkalemia: Give Sodium ____ or Sodium ____
Sodium Bicarbonate
Sodium Lactate
ARF: Dopamine Hydrochloride
used to dilate renal arteries promoting renal perfusion
ARF: to improve renal perfusion, control of hypertension with the use of
ACE inhibitors, diet and weight control
ARF: diet should be high in
CHO
ARF: Screen parenteral fluids, all oral intake, and all medications for hidden sources of
potassium
ARF: Monitor cardiac function and musculoskeletal status for signs of
hyperkalemia
ARF: how should you address Metabolic Rate
reduce it by keeping patient on bed rest
ARF tx: catheters
Avoid indwelling catheters if possible to prevent infection
ARF tx: Bath the patient with
cool water
ARF increases the risk for secondary
infections
ARF can cause 2 kinds of changes in blood composition
anemia
platelet dysfunction
ARF can impair the ability of the body to
heal wounds
Uremic encephalopathy
brain disorder that occurs from ARF
Normally the kidneys excrete ____ of urine per kg of body weight per hour
1 ml
The normal urine output is
1500 to 2000 ml
There are three phases of ARF:
- Oliguric phase 2. Diuretic phase 3. Recovery phase
In the oliguric phase, urine SG is
greater than 1020
In the diuretic phase, K is
decreased
HESI hint: in some cases, people with ARF may not experience
the oliguric phase; instead they go right to diuretic phase.
In the oliguric phase, how much fluid should you give
just enough to replace what was lost (usually 400 ml per day)
Sodium polystyrene (Kayexalate)
may be prescribed if K+ is too high.
EFV, respiratory findings
dyspnea
Pulmonary edema
Salt substitutes are high in
K
Fluids and sodium in ARF patients
should both be limited
ARF diet
low protein
high carb
moderate fat
ARF: rationale for limiting protein
prevents the rise of BUN
ARF is considered resolved when BUN and Cr
return to normal levels
